Provider Demographics
NPI:1275548067
Name:ARIAS, ANDRES J (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:J
Last Name:ARIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 ASHLEY PHOSPHATE RD STE B4
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-6406
Mailing Address - Country:US
Mailing Address - Phone:843-553-7744
Mailing Address - Fax:843-553-7734
Practice Address - Street 1:2810 ASHLEY PHOSPHATE RD STE B4
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-6406
Practice Address - Country:US
Practice Address - Phone:843-553-7744
Practice Address - Fax:843-553-7734
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22122207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC221227Medicaid
SCH31752/5677Medicare UPIN
SCH317528785/8785Medicare PIN